Kantarjian et al identified prognostic factors for a patient with acute lymphocytic leukemia (ALL) undergoing first salvage therapy for induction failure or short first remission. These can help to identify a patient who may benefit from more aggressive management. The authors are from the University of Texas M.D. Anderso Cancer Center in Houston.
Parameters:
(1) age of the patient in years
(2) percent blasts in the bone marrow
(3) platelet count per µL
(4) serum albumin concentration
(5) serum LDH concentration
|
Parameter |
Finding |
Points |
|
age of the patient |
<= 55 years of age |
0 |
|
|
> 55 years of age |
1 |
|
percent blasts in bone marrow |
< 20% |
0 |
|
|
>= 20% |
1 |
|
platelet count |
>= 75,000 per µL |
0 |
|
|
< 75,000 per µL |
1 |
|
serum albumin |
>= 3 g/dL |
0 |
|
|
< 3 g/dL |
1 |
|
serum LDH |
< 1,000 IU/L |
0 |
|
|
>= 1,000 IU/L |
1 |
number of risk factors affecting overall survival =
= SUM(points for all 5 parameters)
number of poor prognostic factors associated with failure to achieve a complete remission = (points for age) + (points for bone marrow blasts) + (points for platelet count)
Interpretation:
• minimum number of risk factors: 0
• maximum number of factors affecting overall survival: 5
• maximum number of factors affecting complete response: 3
|
Score for Complete Response |
1 Year Survival |
|
0 |
41% |
|
1 |
25% |
|
2 |
13% |
|
3 |
0% |
Achieving a complete response is associated with improved survival.
|
Score for Overall Survival |
1 Year Survival |
|
0 or 1 |
35% |
|
2 |
23% |
|
3 |
5% |
|
4 or 5 |
0% |
Specialty: Hematology Oncology
ICD-10: ,
